Colpocytological abnormalities in HIV infected and uninfected pregnant women: prevalence, persistence and progression
| Autor: | Fabiana Divina Fascilla, Paola Cramarossa, Antonella Vimercati, Stefano Bettocchi, Achiropita Lepera, Carmine Carriero |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Uterine Cervical Neoplasms HIV Infections Cervix Uteri Cervical intraepithelial neoplasia Persistence (computer science) Young Adult 03 medical and health sciences 0302 clinical medicine Obstetrics and gynaecology Pregnancy Hiv infected Prevalence medicine Humans 030212 general & internal medicine Pap test Pregnancy Complications Infectious reproductive and urinary physiology Retrospective Studies Colposcopy 030219 obstetrics & reproductive medicine medicine.diagnostic_test Obstetrics business.industry virus diseases Obstetrics and Gynecology Uterine Cervical Dysplasia medicine.disease humanities Italy Disease Progression Female business Pregnancy Complications Neoplastic |
| Zdroj: | Journal of Obstetrics and Gynaecology. 38:526-531 |
| ISSN: | 1364-6893 0144-3615 |
| DOI: | 10.1080/01443615.2017.1373082 |
| Popis: | In this retrospective case-control study, we analyse data of 48 HIV-positive pregnant patients, versus a control group of 99 HIV-negative pregnant women, followed as outpatients by our department from 2009 to 2014. The aims of the study were to investigate the prevalence, persistence and progression of cervical squamous intraepithelial lesions (SIL) in each group and to correlate colpo-cytological lesions to the socio-demographic and clinical-laboratory findings in the HIV + pregnant women. In our study we observed that immunosuppression, HPV infection and vaginal coinfections were predictive of cervical lesions. Pap smear and colposcopy should be part of routine care for HIV-infected pregnant women because these lesions behave aggressively in these patients. Success of prevention depends on massive access of patients to screening. HAART reduces viral load and maintains CD4 count and can affect progression of SIL. Multidisciplinary services on the same site appear to be one promising strategy to improve compliance in patients. Impact Statement What is already known on this subject: Our study provided novel information on a highly vulnerable population of young HIV + pregnant women. What the results of this study add: We observed that immunosuppression, HPV infection and vaginal coinfections were predictive of cervical lesions remarkable with colposcopy. We could consider these important risk factors to evaluate to establish an appropriate strategy of management for these patients. What the implications are of these findings for clinical practice and/or further research: Association of the risk between SIL presence and HIV and HPV infection also deserves additional investigation. We believe that Pap smears and colposcopies should be part of the routine care for HIV-infected women because these lesions behave particularly aggressively in these patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|